“Objectives: This study evaluated the antibiofilm activity of experimental mouthwash containing different concentrations of cannabidiol (CBD) and the in situ effects on the physical and mechanical properties of dental enamel.
Methods: Bovine enamel fragments (6 × 6 × 2 mm) were mounted in intraoral appliances worn by 14 participants in a crossover design. Mouthwash containing CBD (0%, 0.01%, 0.05%, and 0.1%) and 0.12% chlorhexidine (CHX) were tested. Each experimental phase lasted 7 days, separated by washout periods. One side of the appliance was exposed to a cariogenic challenge (20% sucrose) prior to treatment. Surface roughness (Ra), microhardness (%KHN), and color change (ΔE00) were measured before and after treatments. Biofilm and yeast counts (log10 CFU) were quantified, and enamel surfaces were analyzed by scanning electron microscopy. Data were analyzed using two-way ANOVA with Bonferroni post hoc tests and Kruskal-Wallis with Dunn’s test (P < 0.05).
Results: Sucrose did not significantly affect Ra (P > 0.05), although CBD 0.1% showed higher roughness than CHX under sucrose exposure (P < 0.05). No significant differences in %KHN were observed among treatments; however, sucrose reduced microhardness in the placebo and CBD 0.01% groups (P < 0.05). CHX exhibited the highest ΔE00 values (P < 0.05). Biofilm formation was similar among CHX, CBD 0.05%, and CBD 0.1% (P > 0.05), while CHX showed lower yeast counts than CBD 0.01% and CBD 0.1% (P < 0.05).
Conclusion: CBD 0.05% demonstrated potential for biofilm control without adversely affecting enamel properties.
Clinical relevance: This study provides evidence supporting a natural compound-based mouthwash as a clinically viable alternative to chlorhexidine, showing similar efficacy and no associated adverse effects under the conditions tested.”
https://pubmed.ncbi.nlm.nih.gov/42380527
“Chlorhexidine digluconate (CHX) has been considered the gold standard mouthwash in dentistry for several decades. It is a cationic bisbiguanide with bacteriostatic activity at low concentrations and bactericidal effects at higher concentrations. However, its long-term use has been associated with several adverse effects, including taste alteration, tooth and tongue staining, oral mucosal irritation, parotid gland swelling, xerostomia, and the potential development of antimicrobial resistance.”
“Based on the findings of this study and considering its limitations, it can be concluded that cannabidiol-based mouthwashes were able to modulate dental biofilm formation in a concentration-dependent manner, with higher concentrations (0.05% and 0.1%) demonstrating performance similar to chlorhexidine in reducing biofilm accumulation, influencing its structural organization, and maintaining relative microhardness. This effect did not result in alterations to enamel surface topography. However, cannabidiol-based mouthwashes maintained color closer to acceptability thresholds.”
https://link.springer.com/article/10.1007/s00784-026-06985-7